2021 Dunedin Intermediate Lifeguard School Candidate Application Form

Before submitting your application for this season's Dunedin Intermediate Lifeguard School, please check that you have all the required pre-requisites before submitting this application and your club are aware of your application.

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* 1. First Name

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* 2. Last Name

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* 3. SLSNZ Membership Number

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* 4. Club

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* 5. Date of Birth

DD/MM/YYYY

Date

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* 6. Age

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* 7. Gender

Male

Female

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* 8. Email Address

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* 9. Contact number (cell phone)

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25% of survey complete.